Racial Differences in Breast Carcinoma Survival

Sue A. Joslyn and Michele M. West
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

Reviewers: Li Liu, MD
Source: Cancer, Volume 88:114-123, (January) 2000

Précis: African-American women were at increased risk of death from breast cancer


Previous studies have documented a worse prognosis from breast cancer for black women compared with white women. There is also significant interaction between race and stage; black women are more likely to have advanced stages of disease at clinical presentation (JAMA 1994 Sep 28; 272(12): 947-54). In this study, the researchers updated the results of the National Surveillance, Epidemiology, and End Results Program to examine the effects of race on the survival of patients with breast carcinoma.


A total of 135,424 women diagnosed with primary breast cancer between 1988 and 1995 were analyzed.


  • African-American women were 67% more likely to die from their disease than white women.
  • The increased risk of death from breast cancer among African-American women was independent of known variables including patient age, tumor stage, menopausal status, hormone receptor status, and histology.
  • African-American women were younger at the time of diagnosis, were much more likely to be diagnosed with advanced stage breast cancer, and to be diagnosed with estrogen and progesterone receptor-negative tumors.


In this study, African-American women had significantly poorer survival from breast cancer than their white counterparts. Clearly, the specific mechanism by which race affects the clinical course of breast cancer needs continued exploration. Despite our incomplete knowledge, however, many potential contributory factors can be remedied with currently available resources. In particular, physicians must try to ensure that race and socioeconomic status do not limit access to early and appropriate treatment.